Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021

Lord Winston Excerpts

Monday 8th February 2021 Grand Committee

[Lord Winston (Lab) [V]]

First, perhaps I may apologise to the noble Lord, Lord Bethell. On Thursday 4 February, I asked about antiviral drugs: Synairgen’s compound SNG001, an inhaled interferon beta drug, and the controlled trial which had been published in the Lancet and which showed considerable success. I also mentioned ACTIV-2, research established by the National Institutes of Health in the US. With the limits on time to reply to the Statement, I muddled Synairgen’s seemingly effective trial with ACTIV-2, giving the impression that it was a different drug. This made it impossible for the noble Lord to answer my question effectively and I apologise for that.

As many noble Lords have repeatedly affirmed from across the House, we must work together, particularly at times of national emergency. While I speak from these Benches, it is good to celebrate the spirit of proper collaboration of which your Lordships’ House is proud. This is a time of global emergency. Of course, we want to be vaccinated as soon as possible. With vaccines still not plentiful, it is natural to be anxious about ourselves and our families, but we must recognise those elsewhere globally, and particularly in poor nations. It makes economic sense, just as it does with climate change. It may be costly, but it is morally right, and the global fight is essential, not least because of our self-interest.

We should learn from history. Yersinia pestis, the Black Death, caused at least three major pandemics: the plague of Justinian in 1541, the Black Death in 1347 and the Black Death in China in the 1850s. There were repeated, devastating waves in between for many decades. These were spread mostly by travel, by mixing of populations and by people in poverty with poor hygiene and inadequate public health. In 1665, when over 100,000 people in London—probably one-third or more of the population—died in the Great Plague, the greatest proportion were poor and disadvantaged. Lockdown then was rigidly imposed. People were even bolted in their houses, which were painted with a red cross.

The science community has repeatedly warned that we shall almost certainly need to live with Covid for a long time to come. This is likely for Covid-19 but is equally likely to be true of other deadly viruses in due course. So, in addition to global issues, we need everything we can muster: vaccines, better diagnostics, culture facilities, better public health—especially globally—and drugs which kill the virus. We also clearly need isolation, and that will reoccur from time to time. It is important that we do not breathe a huge sigh of collective relief at the blessing of new and better vaccines. There are still many important questions that we will need to consider. Randomised controlled trials must continue. One NIH trial, for example, done in the rhesus monkey, showed that they got protection with different vaccines, but these did not necessarily reduce the replication of the virus in nasal tissues, while some others did. Those are the sorts of reasons why we still do not know how problematic contact between people will be.

Whatever the effectiveness of different vaccines, apart from new mutations, there will be pockets of this virus in the population. If we are to reduce the presence of the virus in our communities, at what stage do we consider vaccinating children? If we eventually do, shall we ignore the serious anti-vaccination protests associated with measles, a far less clinically risky virus? We are relatively safe now from yersinia pestis, not because of vaccines but because of antibiotics. For example, a portable, easily distributed antiviral would be a real asset. Unfortunately, monoclonal antibodies, mentioned by the noble Lord, Lord Walney, in last Thursday’s debate, may not be quite as useful as a portable, easily distributed and administered antiviral, which could give safety, with fewer side-effects, at the early stages of infection. This might kill the virus before it starts to replicate rapidly. That would be useful during lockdown. An antiviral which gets access to the mucus membranes of the throat, pharynx, larynx and respiratory system, taken by mouth or as an aerosol, could be particularly beneficial because that is the route that the Covid virus generally takes. That would be another strategy to avoid the risk of mutations. This may be important, because we must remember how coronavirus is likely to have infected several animal species before moving into man. It is consequently more dangerous. In many parts of this crowded world, humans now perhaps live more closely to animals than at any time in our history.

Of course, we shall continue to jog the Government, but let us do so in the spirit of constructive collaboration that is important at this time of national emergency.

[Baroness Penn (Con)]

My Lords, I remind noble Lords that the time limit for Back-Bench contributions is four minutes.

Covid-19 Update

Lord Winston Excerpts

Thursday 4th February 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend hits the nail on the head. Nothing could be a greater priority to the Government than the opening of all schools, and primary schools are at the top of the list. I pay tribute to all those parents and, if I may be so bold, particularly the mums, who have taken on the bulk of the work in dealing with young children at home while juggling other commitments to care and work. This is one aspect of one of the greatest emotional tolls on the British public. My noble friend is entirely right that the opening of schools is a massive priority. It hits hard those communities that depend on schools for care, and those that do not have the resources for at-home teaching. I completely agree with his assessment and assure him that it is a primary priority of the Government.

[Lord Winston (Lab) [V]]

My Lords, the Minister also hits the nail on the head when he talks about a highly infectious new variant that is resistant to the vaccine. As he knows, the scientists have been pointing out that we will be living with this virus for a very long time, and other viruses like it will emerge in due course. I refer to an answer he gave me last week when I asked about antivirals. There are a number of antivirals in development at the moment in this country that look very promising, an interferon beta-based compound by Synairgen and ACTIV-2, which could be used for ambulant patients in the early stages of the disease. If we got people as soon as they had symptoms and tested positive, we could do a great deal of good and reduce the risk of mutation in the population. Have the Government any plans to do what they did excellently with vaccines: pre-order antivirals as they come through phase 3?

[Lord Bethell (Con)]

The noble Lord is entirely right to raise this issue. There is the awful possibility that the mutant vaccine escape virus could get around the vaccine altogether. We need a plan B, which might be dependent on antivirals as an alternative way of managing the disease. That is what happened with HIV, as we discussed last week. The therapeutic taskforce is looking at antivirals and putting together a plan to upscale our investment in that area. I am aware of Synairgen and ACTIV-2, but he is entirely right that this should now be a greater priority. I will take the matter back for the department to look into further.

Covid-19: Vaccines

Lord Winston Excerpts

Monday 1st February 2021 Lords Chamber

[Lord Winston (Lab) [V]]

My Lords, we welcome the efficiency with which the UK is providing vaccines, but vaccines affect only part of the problem. As my noble friend Lady Thornton and the Minister said, this is indeed a global issue. Prompt diagnosis and early treatment with antivirals will become vital. Time is limited. Can the Minister inform the House what measures the Government are taking to stimulate investment and make urgent research into effective antiviral drugs specifically designed against SARS-CoV-2, which are likely to be easier to distribute in many countries?

[Lord Bethell (Con)]

The noble Lord is entirely right: the vaccines are a hugely important development, but so is investment in all therapeutic drugs. We are extremely blessed to have had a contribution towards dexamethasone, tocilizumab and other therapeutic drugs which have greatly improved outcomes for patients in hospitals. He is right that antivirals also present an opportunity. The reason we have supported research into antivirals through the urgent regime in our clinical trials is to ensure that there is sufficient commitment in hospitals and primary care on antivirals. We are tasking the Therapeutics Taskforce with a specific mandate to look at antivirals and whether we should give greater resources to this avenue of therapeutic development.

Health: Eating Disorders

Lord Winston Excerpts

Tuesday 19th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness is right: the statistics on eating disorders are shocking. The Mental Health of Children and Young People in England Survey identified 0.4% of 5 to 19-year-olds and 1.6% of girls aged 17 to 19. The NHS Digital Adult Psychiatric Morbidity Survey showed 6.4% of adults displaying signs of an eating disorder. There is the survey by Beat, and I could go on. I do not think it is an issue of surveys; we have to address the underlying statistics with measures that make a difference.

[Lord Winston (Lab) [V]]

It is very helpful that the Minister recognises the seriousness of anorexia nervosa and other conditions. It remains puzzling, and the causes are not fully understood, but the long-term risks—for example, infertility or the loss of a child during pregnancy or childbirth—are very serious. Given that some of these patients require almost forced admission to hospital, is there any scope for reviewing this issue when we come to consider the mental health provisions that are due next year?

[Lord Bethell (Con)]

The noble Lord puts it extremely well. Instances of those in pregnancy who have eating disorders are particularly heartrending and disturbing. He is right: sometimes, the condition is so extreme that it needs virtual full admission. We have put six new beds in the south-east, five in the Midlands, five in the east of England and 10 in the north-east. We are putting a massive amount into mental health budgets and this provision covers exactly this kind of disorder because we recognise that more resources are needed. I look forward to further announcements of spending in this area.

Mental Health Act Reform

Lord Winston Excerpts

Monday 18th January 2021 Lords Chamber

[Lord Bethell (Con)]

The right reverend Prelate is right to allude to the importance of culture. No amount of bureaucracy or guideline-writing can ultimately address the basic attitudes, backgrounds and mental starting point of those involved in these decisions. I reassure the House that at the moment we are processing the people plan, which addresses at a fundamental level the hierarchy, racism, homophobia and misogyny sometimes found in some parts of the NHS. We are acutely aware that culture is fundamental to the safe provision of services to patients. The framework itself is not wholly directed at culture, but it will be supplemented by these kinds of reforms.

[Lord Winston (Lab) [V]]

I congratulate the Government on getting Sir Simon Wessely to help them bring about this much-needed reform and will welcome seeing how it progresses in the next year. I want to draw attention to one of the problems about sectioning patients. Two members of my team at different times have been sectioned; both were psychotic and severely depressed at the time. One phoned me at 5 am to say that people had come for her; it was clear that this was highly scary and very damaging. The other patient was left in a police station after being found on a moor for many hours before eventually a bed could be found, miles from where she lived or where anybody could visit her. Also, the premises available for such patients when they have been sectioned seem quite inadequate. The Minister has mentioned the dormitory system, but when I visited both those women, I felt that I would be very depressed myself if I were in those circumstances. We need to do much more to make premises more homely if we are to be more successful in encouraging a return to normal health.

[Lord Bethell (Con)]

The noble Lord is entirely right: when people experience a mental health crisis, they should be treated with consideration. Unfortunately, the police are sometimes at the front line of dealing with those with mental health difficulties. It is a stretch for them, and they should have the right training to be able to deal with a situation sensitively and they should have the right premises to be able to give people safe and secure environments. It is at the outer limits of their professional responsibilities, but we are doing as much as we can to put the training in place.

I remember from my own personal experience, when my father and my mother were sectioned, the consideration and thoughtfulness of those involved in both those processes. It is not all bad, but I take the noble Lord’s point.

Covid-19: Vaccinations

Lord Winston Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful to the noble Lord for flagging this important issue. He is entirely right that those who are sometimes overlooked by society and fall between the cracks are often those who either suffer from the disease or are vectors of infection. It is a public health priority to ensure that people such as those excluded from schools are not overlooked or in any way left behind. I would be very grateful if he could write to me with the details.

[Lord Winston (Lab) [V]]

My Lords, speaking from these Benches, I think it would be appropriate to thank the noble Lord, Lord Bethell, very much for the amazing amount of work he has been doing on this very difficult issue. I hope he will continue to take our concerns back to the Department of Health and the Government in general, because that seems very important. I join my noble friend Lady Thornton in congratulating the Government on getting vaccines out, but, with all due respect, Israel has already vaccinated over one-fifth of its population with a massive vaccine campaign. On the important issue of dividing the time of the Pfizer vaccine, many of us have given informed consent for a period of three weeks between the two injections; by extending that period, we now risk not obeying the consent issue, and therefore there is an ethical problem. Could the noble Lord address that issue, because it is of considerable importance, certainly increasing the risk of suspicion of the vaccine, already very prevalent in parts of the population?

[Lord Bethell (Con)]

I am extremely grateful for the noble Lord’s kind words. I know lawyers looked at the question he raises on informed consent; I am afraid I do not have the precise answer at the Dispatch Box right now, but I will be glad to write to him with a clarification.

Covid-19: Variant

Lord Winston Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am afraid that I just do not recognise the noble Lord’s proposition. Hundreds, if not thousands, of new variants are appearing all the time. Many of them have passed through the process, but identifying those that are threatening, have more transmissibility and are significantly different is extremely complex. As I said very clearly, it was on 8 December that, after analysing all the genomes available in Kent, we showed that an important new variant was circulating.

[Lord Winston (Lab) [V]]

My Lords, clearly these variants are extremely—[Inaudible]—for all sorts of reasons. Regrettably, the Minister did not answer the question put by my noble friend Lady Thornton yesterday, when she questioned incomplete vaccination. Can the Minister give us clear figures on the risk of mutant varieties of the virus with a longer period between the two injections of the Pfizer vaccine?

Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020

Lord Winston Excerpts

Thursday 7th January 2021 Lords Chamber

[Lord Winston (Lab) [V]]

My Lords, I had the privilege of sitting on the Select Committee that looked at the virus. The committee was brilliantly chaired by the noble Lord, Lord Patel, who has already spoken. One thing we heard was that this virus occurred from a mutation and that mutations were likely to be possible in future. The fact is that the more people who are infected in a population, the greater the likelihood of mutation that may be deleterious to human health, and the more treatment that is given to people, the more likely there is to be a mutation, as the virus fights against that treatment.

Of course, people who come from outside your environment—for example, from outside the country—are more likely to bring such mutations in with them. One of the clear issues, which was not properly answered by the noble Baroness, Lady Evans of Bowes Park, earlier today, when she answered the noble Viscount, Lord Waverley, I think, is what we are doing about international travel, a point already raised very ably by my noble friend Lord Reid. It seems to me, looking at the figures for people coming through London airports, that hundreds of thousands of people are coming through on a weekly basis and we are not properly tracking or tracing them. Some of them are being asked if they might like voluntarily to be tested, and of course they have to pay for it. That is clearly nonsense. There should be much stricter controls on people coming into this country, as is happening in other countries. I ask the noble Lord, Lord Bethell, exactly what we are going to do now, because at present the Government do not seem to have a firm policy to do something to make sure that we are not bringing more viruses, which may be mutating in some cases, into this country.

Covid-19 Update

Lord Winston Excerpts

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I feel the point that my noble friend makes extremely personally. I am currently isolating with a 14 year-old; like many 14 year-olds, he and his friends never demonstrate any symptoms of Covid whatever and yet it would seem that they are carriers and vectors of the infection. The recent explosion in transmission in London and the south-east was led and probably caused by the 14 to 18-year-old age group, even though almost all of them are completely asymptomatic. We have worked with celebrities and opinion leaders in the youth groups to try to get this message across, but I point my noble friend to the announcement today of a very large increase in the use of asymptomatic testing in schools in the new year, as an indication of our commitment to ensuring that transmission among asymptomatic young people is contained.

[Lord Winston (Lab) [V]]

I thank the noble Lord for repeating the Statement. I concur with what the noble Baroness, Lady Thornton, said from the Front Bench. We know from the history of plagues that they occur through travel. This happened in the 1340s and again in the 1660s with the plague of London. Now we are seeing people travelling to London, which is a massive hub of travel; they come to the airport, they do not leave a phone number or address—they are not required to do so—and tests at the airport are voluntary. Many people go missing and are not followed up by a proper track. When they get tested, they pay for it, so it is entirely voluntary. Does the noble Lord feel that these arrangements are sufficient, given that so many people travel to London and that there is a risk of this plague continuing just as they have done historically?

[Lord Bethell (Con) [V]]

I am grateful for the noble Lord’s insight. He is right that travel is the friend of the virus. Many of the growths in transmission have been associated with it; one thinks of the ski resort holidays at the beginning, the spring break migrations in America and other examples. I reassure him that, while he is right to question the arrangements around our airports and transport hubs, we have brought in a much more strenuous test to release programme which is much more realistic than the previous isolation programme. The procedures around the passenger location ports have been tightened up and the enforcement and tracking arrangements for passengers have been supplemented. There is now a very strong body of evidence to suggest that passengers are abiding by the testing programme. As he may know, private tests were launched yesterday, and their uptake has been incredibly impressive.

Health: Sepsis

Lord Winston Excerpts

Wednesday 22nd January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I am very happy to congratulate the BBC. I do not know that I heard “The Archers” storyline in question, but I shall make sure that I update my education in this respect. I want also to congratulate Public Health England on its national Start4Life information service for parents. It has worked with Mumsnet to make sure that awareness is spread to those most likely to need it, because those most at risk are the young, the elderly and those who have underlying conditions. Targeting the messaging at those who need it most is very important.

[Lord Winston (Lab)]

My Lords, the noble Lord, Lord Grade, raises a very important point. Can the Minister tell us what percentage of patients with sepsis have the DNA profile of the bacteria recorded?

[Baroness Blackwood of North Oxford]

The noble Lord, Lord Winston, always raises very specific questions requiring statistical answers which are not necessarily at my fingertips. I shall write to him on that point.